Integrative Pain Management

Long gone are the days of house calls when a doctors could bring all of themselves to a patient’s bedside. I’d like to think that with these gestures of compassion, doctors were also more mindful. Although unlikely that they would have had a formal meditation practice, the past state of affairs in medicine created an environment more conducive for at the very least, thoughtfulness. Fast-forward to 2011 where medicine has made many advancements and cures for the better, but we as physicians have lost touch of a crucial healing and diagnostic tool in our armamentarium. This tool being mindfulness. It is with mindfulness that we can invite a patient to be fully present with us and us with them. Even if there is only a 15-minute timeslot forced upon us by an HMO, we can be there for the entire 15 minutes. Being mindful refocuses the doctor-patient relationship to one of trust and respect. Until very recently, doctors have not learned about the benefits of incorporating mindfulness into their practices for the benefit of their patients and for their own personal benefits. When a physician has a mindfulness practice, they can acknowledge what they are bringing into each patient encounter and how this affects their ability to listen without judgment, engage without fear, and discuss their plan with compassion and clarity.

Mindfulness also creates opportunity for the patient to have a greater role as a participant in his or her own health care. By incorporating mindfulness practices into their health strategy, a patient realizes that they do have control over aspects of their care and even more importantly, control over their thoughts that affect theperception of their disease. Mindfulness helps us to realize that pain and disease are a part of life. Often we have no control over what happens to us, but we do have control of how we react to it. Our suffering is a state of mind that we allow to fester, grow, and define us. Mindfulness allows us to see that while we may not be able to control the first arrow, the car accident, the cancer, the lupus, etc., we can control whether we self inflict a second arrow. We can either acknowledge our pain and move ahead with acceptance or we can fight against it and constantly be searching for a way out. Often times there does not need to be a way out. Rather, we would benefit from finding a way of better living with it, whatever that “it” is.

Mindfulness practices, such as loving-kindness meditations, cultivate compassion, empathy and a greater sense of community. These techniques also help one to realize that they are not alone in their pain or disease. Rather, there are others that are also experiencing pain and disease of their own. This can bring great comfort to someone who feels isolated by his or her malady, thereby facilitating a sense of well being.

By cultivating mindfulness, the patient can learn to embrace their disease as an opportunity for growth and change. With mindfulness we become aware how our emotions of fear, anxiety, doubt, anger, etc. contribute to our make our disease process worse and less manageable, manifesting and prolonging more unnecessary suffering. When we acknowledge the times when we have added to our suffering with the second arrow effect, the subsequent times when we do so, we can observe this and try not get entangled further. Each exercise in this builds our strength against our own dramatic tendencies to make a situation worse than it needs be. When we can figure out that we don’t need anything extra in terms of drama or aggravation, we learn to let these tendencies go. By creating a stronger foundation we are able to act with acceptance and compassion for ourselves the next time a wave of nausea overwhelms on our post chemo drive home or the next time our back sends a shooting pain down our leg. With each set of good or bad news from the doctor, we can accept it with greater peace and equanimity. Mindfulness may not cure all of our afflictions, but it certainly does help us to live more fully. By embracing both the good and the bad, while remaining detached from the second arrow, our quality of life improves.

So much of healing deals with appropriate decision making. When we are mindful, making healthy decisions is easier. Part of healthy decision-making means recognizing how stress negatively affects our health and trying to mindfully bring less stress upon ourselves. Stress is linked to inflammation and inflammation in turn is the great mastermind behind disease manifestation. Stress leads to respiratory disease, headaches, anxiety, depression, cardiovascular disease, and gastrointestinal irritability, to only name a few. Mindfully focusing on our breath not only increases the oxygen content in our blood thereby delivering vitality and nourishment to our cells, but the breath invites our tightly wound nervous system to take a breather too. Decreasing stress decreases cortisol, which in turn decreases inflammation. If we can be mindful and try to lessen the stress in our lives, we can likely prevent disease worsening or possibly even prevent some diseases altogether. By engaging in practices that employ mindfulness, such as a formal sitting practice, breathing techniques, yoga, etc. our stress levels decrease and the way we manage the remaining stress is facilitated. Even better yet for our health is when we can bring our mindfulness with us throughout our day, becoming wholly mindful.

With mindfulness,we go to bed earlier rather than exhausting ourselves, we pick up the salad instead of the doughnut (sugar=inflammation!), we take the stairs instead of the elevator, and we say, “I love you” to our loved ones and ourselves. We engage in behavior that protects and heals rather than aggravates and increases inflammation. We chose kindness and compassion in the face of whatever disease may be coming along for the ride in our bodies. We harness mindfulness to step out of an “I am this disease X” state of mind to instead allow the joy inherent within ourselves to illuminate our souls.

Physical defeat allows for surprising opportunity for self-inquiry and learning. It is not uncommon that goes an entire day running from appointment to appointment without really thinking about anything. But when physical sickness forces us to slow down, especially the chatter in our heads, the opportunity for mindfulness is unexpectedly available. This is opportunity to embrace sickness and disease as avenues to becoming more aware and present. Disease and pain can be harnessed as invitations to be mindful. Life includes joy and sorrow. Being able to mindfully engage all of what life throws our way, arrows and the like, only magnifies our experience of joy. Being able to recognize how our thoughts affect our perception of disease is more than half the battle. We are in control of our happiness, whether we are sick or not. Suffering is a choice. With each breath we can invite opportunity for healing, change, and well being. With each breath we can choose to live fully.

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Pacifica Orthopedics

Huntington Beach (Main Office)

18800 Delaware Street, Suite 1100 Huntington Beach CA 92648

714.841.5333

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Pacifica Orthopedics is a leading Orthopedic Care Center serving the community for over 25 years.